Purpose: 

Intensive cardiac rehabilitation (ICR) was developed to enhance traditional cardiac rehabilitation (CR) by adding sessions focused on nutrition, lifestyle behaviors, and stress management. Intensive CR has been Medicare-approved since 2010, yet little is known about national utilization rates of ICR in the Medicare population or characteristics associated with its use.

Methods: 

A 5% sample of Medicare claims data from 2012 to 2016 was used to identify beneficiaries with a qualifying indication for ICR/CR and to quantify utilization of ICR or CR within 1 yr of the qualifying diagnosis.

Results: 

From 2012 to 2015, there were 107 246 patients with a qualifying indication. Overall, only 0.1% of qualifying patients participated in ICR and 16.2% in CR from 2012 to 2016, though utilization rates of both ICR and CR increased during this period (ICR 0.06 to 0.17%, CR 14.3 to 18.2%). The number of ICR centers increased from 15 to 50 over the same period. There were no differences between ICR and CR enrollees with respect to age, sex, race, discharge location, median income, dual enrollment, or number of comorbidities. Compared with eligible beneficiaries who did not attend ICR or CR, those who attended either program were younger, more likely to be male and White, and had higher median income.

Conclusions: 

Although ICR and CR have a class 1 indication for the treatment of cardiovascular disease and the number of ICR centers has increased, ICR is not widely available and remains markedly underutilized. Continued research is needed to understand the barriers to program development and patient participation.

中文翻译：

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医疗保险受益人明显未充分利用强化心脏康复：2012-2016 年全国样本结果

目的： 

强化心脏康复 (ICR) 旨在通过增加专注于营养、生活方式行为和压力管理的课程来增强传统心脏康复 (CR)。自 2010 年以来，强化 CR 已获得医疗保险批准，但人们对全国医疗保险人群中 ICR 的使用率或与其使用相关的特征知之甚少。

方法： 

使用 2012 年至 2016 年Medicare索赔数据的 5% 样本来确定具有 ICR/CR 合格指征的受益人，并量化合格诊断后 1 年内 ICR 或 CR 的利用率。

结果： 

2012年至2015年，有107,246名患者符合合格指征。总体而言，2012年至2016年间，只有0.1%的合格患者参与了ICR，16.2%的合格患者参与了CR，尽管在此期间ICR和CR的使用率均有所增加（ICR 0.06%至0.17%，CR 14.3%至18.2%）。同期，ICR 中心的数量从 15 个增加到 50 个。ICR 和 CR 登记者在年龄、性别、种族、出院地点、收入中位数、双重登记或合并症数量方面没有差异。与未参加 ICR 或 CR 的合格受益人相比，参加任一计划的受益人都更年轻，更有可能是男性和白人，并且收入中位数更高。

结论： 

尽管 ICR 和 CR 具有治疗心血管疾病的 1 类适应症，并且 ICR 中心的数量有所增加，但 ICR 并未广泛使用，并且仍然明显未得到充分利用。需要继续研究以了解计划开发和患者参与的障碍。